Decreasing the Risk of Delirium in the Hospitalized Elder

According to Dr. Sharon K. Inouye and her colleagues at Yale University School of Medicine, more than 2 million older Americans will develop develop delirium and functional decline during a hospitalization.  This could result in increased mortality and morbidity, longer hospital stays due to complications or a transferred to a long-term care facility.

With that in mind, we must be proactive in trying to reduce the odds of delirium occurring when our aging parent or loved-one becomes a hospital patient.

By taking the following ten steps, you may be able to reduce the risk of delirium:

1. Bring  a complete list of all medications (and their dosages), as well as a list of all over-the-counter medicines to the hospital with the patient.  It may help to bring the medication bottles as well.
2. Prepare a “medical information sheet” listing all allergies, names and phone numbers of physicians, the name of the patient’s usual pharmacy and all known medical conditions. If you have any reports such as CT scan results, recent lab tests or notes from a recent doctor visit, bring those too.
3. Bring glasses, hearing aids (and extra batteries), and dentures to the hospital. Older persons do better if they can see, hear and eat.
4. Bring in a few familiar objects from home. Things such as family photos or favorite photos in an album, a pillow, a favorite comforter or blanket for the bed, rosary beads, a beloved book and relaxation tapes can be quite comforting.
5. Help orient the patient throughout the day. Speak in a calm, reassuring tone of voice and tell the patient where he is and why he is there.
6. When giving instructions, state one fact or simple task at a time. Do not overwhelm or over stimulate the patient.
7. Massage can be soothing for some patients, but remember that for others, it can be over-stimulating.
8. Stay with the hospitalized patient as much as possible. During an acute episode of delirium, relatives or perhaps friends should try to arrange shifts so someone can be present around the clock.  If family is not close, and it is affordable, ask about having a “sitter” present.
9. If you detect new signs that could indicate delirium — confusion, memory problems, personality changes — it is important to discuss these with the nurses or physicians as soon as you can. Family members are often the first to notice subtle changes.
10. Find out more about delirium. The American Psychiatric Association’s “Patient and Family Guide to Understanding and Identifying Delirium” is available on line.

Adapted from The Hospital Elder Life Program 2007